Reshuffling the DRG Deck
DRG or Diagnosis-Related Groups are mainly factions that have the authority to alter completely or modify the hospital operational procedures and/or balance sheets, and since the commencement of the government's fiscal year on October 1st 2006, they have grown largely in number.
When interviews had been conducted to get the point-of-views and responses of the hospital administrators to the increase in DRGs, two main introductions seemed to be the focal points: one being the introduction and execution of 12 brand new Cardiac DRGs; which had been given praiseworthy reviews as it presented fresh refund opportunities for the diversified and specialized hospitals; and, the second being altered status of 182 DRGS so that they encompassed the post-acute-care transfers in the agenda as well; this change, however, met varied responses.
What's most evident is the addition of 16 DRGs, omission of 10 old DRGs and alteration in the structure of the remaining to align the Medicare finds in a more suitable and practical way with the norms and standards of hospital procedures.
Overall, the efforts made by CMS to the DRG structure and to construct a more stable financial input-output for the angioplasty and bypass surgery have been praised and welcomed; the CMS justifies the changes that have been made as an effort to make sure in an efficient way that no form of care is provided twice (part of the hospital's imbursement for the DRG and/or as a detached fee to the post-acute service) unnecessarily by the Medicare Service Providers.
The underlying risk here, however, is the investment of millions of dollars allotted in the Medicare budget; the downside or failure of a project could not lead to a profit or loss situation but merely to a shift in the budgeting from one section to the other.
Bibliography
Do Bias M, Becker. Oct 10, 2005: 35(41): 6-7, 16, 1. C Mod Health
Crain Communications, Incorporated Oct 10, 2005.
